Effectiveness of multicomponent interventions for children and adolescents with overweight or obesity: a systematic review and meta-analysis

Pediatric overweight and obesity are major public health challenges associated with cardiometabolic, hepatic, respiratory, and psychosocial complications. Multicomponent lifestyle interventions combining dietary, physical activity, behavioral, family-based, school-based, and digital strategies are widely recommended for pediatric weight management. However, their pooled effects on commonly reported anthropometric outcomes remain uncertain. This systematic review and meta-analysis evaluated the effectiveness of multicomponent lifestyle interventions among children and adolescents with overweight or obesity. Eligible studies were randomized controlled trials enrolling children and adolescents aged 4–18 years with overweight or obesity and evaluating interventions with at least two coordinated components, including dietary modification, physical activity promotion, behavioral therapy, psychological support, family involvement, school-based support, or digital follow-up. The primary outcomes were body weight, BMI, BMI standard deviation score, and waist circumference. Pooled effects were calculated using mean differences, as appropriate, with 95% confidence intervals. Eighteen studies were included, involving 931 participants in the intervention groups and 898 participants in the control groups. Compared with control conditions, multicomponent lifestyle interventions were associated with significant reductions in body weight (MD = − 1.96, 95% CI − 2.53 to − 1.39, P <0.00001),BMI (MD = − 0.63, 95% CI − 1.05 to − 0.21, P = 0.004༉,BMI-SDS(MD = − 0.08, 95% CI − 0.13 to − 0.03, P = 0.001༉, and waist circumference (MD = − 1.84 cm, 95% CI − 2.50 to − 1.17, P < 0.00001). Multicomponent lifestyle interventions were associated with modest improvements in body weight, BMI, BMI-SDS, and waist circumference among children and adolescents with overweight or obesity. Although these findings are encouraging, heterogeneity in intervention components, intensity, duration, delivery setting, and control conditions highlights the need for more standardized trials and longer-term follow-up.